A complication associated with dorsal penile nerve block.
A case describing a 2-day-old term male infant who received a dorsal penile nerve block (DNPB) prior to circumcision, inadvertently with 1:1000 epinephrine, is presented. The patient had a brief hemodynamic response followed by profound vasoconstriction and ischemia of the genitalia. A caudal catheter was inserted and a sympathetic block established in an attempt to antagonize the epinephrine-induced vasoconstriction. The patient's condition improved and no residual effects of the ischemia were noted. A review of complications associated with DNPB and of epinephrine-induced penile ischemia is briefly discussed.
Berens
R
R
Department of Anesthesiology, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee 53201.
Pontus
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SP
D002944:Circumcision, Male; D003251:Constriction, Pathologic / Q000139:chemically induced; D004837:Epinephrine / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D007511:Ischemia / Q000139:chemically induced*; D008297:Male; D009407:Nerve Block; D010413:Penis / Q000098:blood supply / Q000294:innervation*
D004837:Epinephrine